Champion, Penny L

Champion, Penny L is an individual health care provider with primary practice located at 414 5Th Ave , Albany GA 31701-1976. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Champion, Penny L can be contacted via phone (229) 883-4555.

Contact Information

Primary practice address
414 5Th Ave Albany GA 31701-1976
Phone: (229) 883-4555
Fax: (229) 888-0063
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X R079412 Georgia

Profile Details

NPI number 1265425797
LBN Legal business name Champion, Penny L
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2005
Last updated Dec 9th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265425797 NPPES
Georgia MEDICAID 00787146A

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